No.
01 - 08
Date: October 18, 2001
New York State
Department of Health
Bureau of Emergency Medical Services
POLICY STATEMENT
Re:
Unknown Dry
Substance / Suspected
Anthrax Response
Advisory
Supercedes/Updates:
Page
1 of 3
ADVISORY FOR RESPONSE TO PATIENTS EXPOSED TO UNKNOWN SUBSTANCES
PLEASE DISTRIBUTE IMMEDIATELY
This advisory is being sent to you to assist when responding to an emergency
call involving a package, envelope or substance suspected of being Anthrax.
Also attached are Anthrax advisories/protocols developed by the Department of
Health to assist you in understanding what Anthrax is, mail handling protocols,
recommended patient/equipment, decontamination guidelines, specimen
handling and criteria for lab testing.
There are some primary things to understand about responding to an
emergency medical response which involves a call site alleged to contain
Anthrax or involving an unknown powder/substance:
1.
Confirm scene safety and type of incident. Responding EMS agencies are NOT
advised to enter an affected area until a competent authority has determined the
scene to be safe.
2.
If your arrive on the scene first, notify competent authority.
3.
If an unknown substance has been found in the air handling system, evacuate
the premises immediately and notify the competent authority.
4.
Anthrax is NOT contagious. Person to person transmission has never been
reported.
5.
There will be little or no need for prehospital medical care. Do not
transport the individual to a hospital, unless other medical conditions need
to be addressed (i.e., chest pain, severe anxiety). Patients should not be
transported to a hospital.
6.
If patient insists on being transported to the hospital, contact medical control for
physician consultation.
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7.
If you transport to the hospital, notify the receiving hospital that you are bringing
a patient who has been exposed to a powder/unknown substance and request
the hospital to have staff meet you outside of the Emergency Department.
8.
Create a list of individuals who were in area of exposure to be given to the
incident commander or local police and shared with local public health officials.
All, or most individuals, should be released home with the self-monitoring
instructions attached.
9.
The need for testing of the substance will be determined by appropriate
authorities following risk assessment.
10.
Unless a lab test confirms the nature of the powder substance, there is no need
to immediately initiate prehospital medical treatment. These lab tests take at
least 24 hours to complete. There is no harm to an individual waiting for lab
results before beginning appropriate medical treatment
11.
The Centers for Disease Control (CDC) has advised that no treatment is
necessary for Anthrax in an otherwise healthy person exposed to an unknown
powder/substance.
12.
If you arrive at the scene and patient(s) have been decontaminated, you should
follow the above guidelines, but assist in addressing individual concerns about
infection and treatment.
13.
If you enter a scene and the patient has not been decontaminated and there is
an observable substance, contact a competent authority and perform the
following:
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14.
If the patient has a powder or other substance on their skin or clothing,
ask the patient to remove their outer clothing. If the patient is not able to
undress themselves, put on PPE1 and remove the patients outer or
exposed clothing.
Provide the patient with a disposable garment or a sheet.
The patient’s clothing should be secured by the patient (if possible), in a
clear plastic bag and left with the competent authorities on the scene.
See attached Decontamination Advisory. This should be followed by the
appropriate local agency responsible for decontamination. EMS is not
generally responsible for decontamination.
Remember you are considered health care providers who the public expects will
be knowledgeable about Anthrax. Often, you will be the highest medical
authority at the scene. Please review the attached materials and be prepared to
work with local or state public health officials in calming public fears regarding
these incidents.
NOTE: This guideline is being provided to your local REMAC
for incorporation into local protocol.
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Personal Protective Equipment (PPE) - Gloves, mask and eye protection. These may
not be necessary on every call. Use the appropriate PPE based on the patient assessment and
the presence of blood or body fluids and pertinent past medical history.
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Attachments
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DOH Anthrax Fact Sheet
Protocol for Mail Handling
Decontamination Advisory
Patient Self-monitoring Instructions
Criteria For Wadsworth Laboratory Testing
Protocol for Submitting Environmental Samples for Laboratory Testing
cc: Regional Emergency Medical Advisory Committees
County EMS Coordinators
Regional DOH Offices
State Emergency Management Office
County Emergency Managers
County Fire Coordinators
County Hazmat Teams
County/City Health Departments
New York State Police
Sheriffs Association
Hospital Emergency Departments
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